On Old Age (and Ezekiel Emanuel)

In a much-discussed Atlantic essay, “Why I Hope to Die at 75,” Ezekiel Emanuel — physician, public commentator, and prominent supporter of the Affordable Care Act — argues that we’d all be better off if we died at 75. That way, we would escape the debility and indignity that accompany old age and avoid being burdens to our children and other loved ones. And we would have the solace of not outliving our productivity. After all, he writes, “by 75, creativity, originality, and productivity are pretty much gone for the vast, vast majority of us.” Emanuel has no plan to commit suicide if he reaches 75, he says. But he plans to reject all medical treatments, even routine ones, that go beyond the palliative.

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He Knew

Emanuel rightly mocks “American immortals” who seem to believe they should (and maybe will!) live forever. And, in a culture like ours, which values youth and professional achievement virtually above everything else, his argument has a kind of plausibility. I’ve had 25 year-old students tell me they already feel over the hill. Why linger on into your eighties or nineties, when your best days and accomplishments are far behind you? Plus, society would save lots of money if people stopped seeking medical care at 75.

Nonetheless, there’s a serious flaw in Emanuel’s thinking. Strength, health, creativity — these are good things, but they are not the only things that give life meaning. From a Christian perspective, for example, the point of life is to express gratitude to and love for the Lord, and this we can do at any age. In the fullness of time, God will call each of us; until then, we have to try our best. There’s no point rushing Him.

Not everyone believes this, of course. But one needn’t be a Christian, or a religious believer of any kind, to appreciate that old age has some things to offer. “For old men who are reasonable and neither cross-grained nor churlish find old age tolerable enough: whereas unreason and churlishness cause uneasiness at every time of life,” said the pagan Cicero (above). And one needn’t be a religious believer to see that the elderly may still have much to contribute to us, even if they are weak, sick, and no longer able to write symphonies.

In a lovely response to Emanuel, my friend, John McGinnis, explains this, offering his own parents as an example. John does a much better job than I could, so I’ll just quote him:

But youth and good health do not measure humanity. Millions in diminished health enjoy life, being with their relatives, laughing at old movies, even just sitting in the breeze and sunshine. And their relatives and friends enjoy being with them. Indeed, they may find in the elderly’s struggle with aging an inspiration and a reaffirmation of life. In caring for the frail, weak and sometimes woebegone, they may also expand their own sympathies and express some small measure of gratitude for the debt of a good upbringing that can never be fully repaid.

That is certainly my experience watching my parents age well past 75. I have never admired my father more than when at the cusp of ninety he faces down his own infirmities and cares for my mother who has Parkinson’s disease. And although much is taken from my mother, much abides—her concern for others, her delight in reading new novels and rereading old ones. Emanuel argues that in seeing the decline of those we love, we may forget our happy memories of them in their years of vigor and achievement. But those memories do not need to summoned at particular times, because they infuse my being. In any event, the most valuable memories of all are not defined by physical wellbeing but by spirit and character. For so many people beyond 75 the forging of character continues and the power of their spirit at their end will instruct us by example at our own.

For one important thing, though, Emanuel is to be commended. Most of us do our best to ignore our mortality and the questions it raises about how we’re living our lives. As Pascal observed long ago, people will do pretty much anything to distract themselves and avoid thinking about it. That’s not wise; even a long life goes by so very fast. Every writer knows the benefits of deadlines: they force you to concentrate and get serious. Well, Emanuel says, he’s given himself a deadline.

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